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Associations between Air Pollution Indicators and Prevalent and Incident Diabetes among African American Participants in the Jackson Heart Study
Citation:
Weaver, A., A. Bidulescu, G. Wellenius, D. Hickson, M. Sims, A. Vaidyanathan, W. Wu, A. Correa, AND Y. Wang. Associations between Air Pollution Indicators and Prevalent and Incident Diabetes among African American Participants in the Jackson Heart Study. Environmental Epidemiology. Wolters Kluwer, Alphen aan den Rijn, Netherlands, 5(3):e140, (2021). https://doi.org/10.1097/EE9.0000000000000140
Impact/Purpose:
Diabetes is a major public health issue, particularly for African Americans. Investigating potential associations between air pollution and diabetes is an emerging research area in environmental epidemiology. We examined associations between long-term (1-year and 3-year) exposures to fine particulate matter (PM2.5) and ozone (O3) with incident and prevalent diabetes among a cohort of 5231 African Americans enrolled in the Jackson Heart Study. We observed associations between O3 exposure and incident, but not prevalent, diabetes. We did not observe associations between PM2.5 exposure and incident or prevalent diabetes. This study concurs with the few previous studies that have been conducted in this area and is among the first to be conducted among African Americans.
Description:
Type 2 diabetes mellitus (DM) is a major risk factor for cardiovascular disease (CVD) and is especially prevalent among African Americans. Prior studies suggest that long-term exposure to ambient air pollution is may be associated with greater incidence of DM, but results remain heterogeneous and few studies have included large numbers of African Americans. We assessed DM status among African American participants of the Jackson Heart Study, an ongoing prospective cohort study, at visit 1 (2000-2004, N = 5231) and visit 2 (2005-2008, N = 2845). We estimated residential levels of 1-year and 3-year fine particulate matter (PM2.5) and ozone (O3). We used mixed-effect modified Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of the association between markers of air pollution exposure and prevalent DM at visits 1 and 2, and risk ratios (RR) of indicators of air pollution exposure at visit 1 and cumulative incidence of DM at visit 2. We adjusted for potential confounding by patient characteristics and comorbid conditions, as well as inverse probability weights of DM at visit 2 and accounting for clustering by census tract. We did not observe associations between 1-year or 3-year PM2.5 and incident or prevalent DM. We observed a positive association between 1-year O3 and incident DM at visit 2 (RR = 1.12, 95% CI 1.04, 1.20). Our results provide some evidence of possible positive associations between indicators of long-term O3 exposure and DM. However, we did not observe associations with PM2.5. This study is particularly relevant to African Americans, who have higher prevalence of DM but relatively few studies of environmental pollution risk factors.
URLs/Downloads:
DOI: Associations between Air Pollution Indicators and Prevalent and Incident Diabetes among African American Participants in the Jackson Heart Study